| 查看: 69 | 回复: 2 | |||
| 当前主题已经存档。 | |||
| 当前只显示满足指定条件的回帖，点击这里查看本话题的所有回帖 | |||
[交流]
世界肾脏日,你我共关注
|
|||
|
World Kidney Day（世界肾脏日） 'Early Detection and Prevention of Chronic Kidney Disease' “早期检测和预防慢性肾脏疾病” IFKF Activities - World Kidney Day 2006 - Thursday March 9 2006 2006年世界肾脏日：2006年3月9日 星期四 The International Federation of Kidney Foundations (IFKF) and the International Society of Nephrology (ISN) have jointly launched World Kidney Day. The partnership website www.worldkidneyday.org provides extensive information, the official WKD banner and other press mediat kit material to support your promotions, activities and events to celebrate our first World Kidney Day. Each year World kidney Day will be held on the second Thursday of March, beginning Thursday March 9 2006. The principal focus of World Kidney Day (WKD) is to raise awareness among general physicians and primary healthcare professionals of the role of the kidney as a risk marker in related chronic diseases (such as diabetes and cardiovascular diseases) and the pressing need for early detection of any form of kidney impairment. Please make every effort to increase awareness of chronic kidney disease and its associated cardiovascular morbidity and mortality. Early detection can be accomplished through systematic testing for serum creatinine or urine albumin â?“ particularly in high risk individuals - over 50, in individuals who are obese; who smoke; who have diabetes (or a history of diabetes in the family) or have hypertension. World Kidney Day: An Idea Whose Time has Come Developed by the International Federation of Kidney Foundations (IFKF) and the International Society of Nephrology (ISN), Committee for World Kidney Day; Allan J. Collins, William G. Couser, John H. Dirks, Joel D. Kopple, Thomas Reiser, Miguel C. Riella, Sudhir V. Shah, Anne Wilson. The world needs a kidney day to draw attention to the increasing global pandemic of kidney and associated cardiovascular disease. Therefore the International Society of Nephrology (ISN) and the International Federation of Kidney Foundations (IFKF) are jointly proposing that a World Kidney Day be established on the second Thursday in March each year. It will be launched on Thursday March 9, 2006 and fully inaugurated on Thursday March 8, 2007. The aim is to broadcast the message about kidney disease to government health officials, general physicians, allied health professionals, individuals and families. Worldwide, most individuals with chronic kidney disease or hypertension are not diagnosed until long after the illness has developed. Moreover, when they are diagnosed they are too often treated sub-optimally or not at all. In most parts of the world, once end stage kidney failure occurs, patients do not have access to maintenance hemodialysis treatment or kidney transplantation and simply die. For these reasons, it is time to speak up and to speak clearly because the extent and severity of kidney disease has for a long time not been appreciated. Moreover, the availability of easy methods for early detection and the proven benefits of preventive therapy are not widely known. A day when attention to kidney disease is brought to the world’s population is timely. It could also serve as a day to express appreciation for the billions of dollars of support for a disease that currently requires high technology treatment. Kidney disease is a significant disease in patients with diabetes, hypertension and cardiovascular disease with major morbidity and mortality and high costs to the healthcare system. Moreover, patients with chronic kidney disease have a marked increase in risk for developing cardiovascular disease. However, as kidney disease is easy to detect with simple, routinely available tests (serum creatinine and urine albumin), both chronic kidney disease and the potential associated cardiovascular complications can be effectively treated and prevented with intensive blood-pressure control, glucose control in diabetic patients, lipid-lowering medications and the use of kidney-protective medications such as angiotensin-converting enzyme inhibitors or angiotensin receptor blockers., Prevention and slowing the progression of chronic kidney disease are the only rational public health approaches to addressing the ever-increasing numbers of end-stage renal disease patients and reducing the associated cardiovascular risk in these patients. The decision makers of public health and biomedical science view kidney disease as infrequent and costly. However, newer information and scientific evidence have given persuasive evidence that there is more kidney disease than had been thought. Developed countries worldwide treat over 1,000,000 individuals yearly, and as many as 250,000 new cases each year.1 In the US and the Netherlands it is estimated that 6.5-10% of the general population suffer from some degree of kidney disease and are therefore at increased risk of preventable cardiovascular disease and renal failure. Kidney disease is increasing rapidly in the developing world, along with the prevalence of diabetes and hypertension . However, since dialysis costs can average $65,000 per year and a transplant can cost up to $40,000, neither is available to the vast majority of people living outside the developed world. Some emerging evidence points out that end stage kidney disease rates are slowing and in fact decreasing in certain populations. These trends are consistent with increased use of the new drugs referred to above, (angiotensin converting enzyme inhibitors and angiotensin receptor blockers), and with better blood pressure control and better control of blood sugar in diabetic patients. Yet worldwide there is a pandemic of type II diabetes and associated metabolic syndrome, so there continues to be substantial room for improvement. The number of patients with type II diabetes worldwide will increase from 154 to 360 million by 2030, with at least 40% of these patients developing chronic kidney disease with its associated increased risk for cardiovascular disease, and over 10% developing end-stage kidney disease unless aggressive measures of early detection and intervention programs are initiated. Intensified efforts should yield further reductions in end stage kidney disease rates, at least in the short run, with more data needed to determine if decreases are sustainable.2 The public health mandate is clear for governments: detection and prevention are the most cost-effective methods to address chronic kidney disease and its impact on diabetes and cardiovascular disease. Targets have been defined for blood pressure. Early referral to nephrologists for more complete assessment of interventions, as well as other preventive-care measures including influenza vaccinations and pneumococcal vaccinations, are needed to reduce hospitalization rates for infectious complications that are four times higher in the chronic kidney disease population.4 Detection efforts center on accurate measurements of serum creatinine and albumin in the urine to assess the level of kidney disease.3 Strategies to standardize these measurements should become a global priority. Patients who enter dialysis or receive kidney transplants experience the most direct consequences of kidney disease, early detection and intervention could have saved the ravages of kidney failure. Because of genetic linkages between diabetes and hypertension, the leading causes of kidney failure, kidney disease runs in families. Genetic diseases, such as polycystic kidney disease among others, and genetic abnormalities also run in families. In some developing countries malaria, HIV/AIDS, tuberculosis and childhood infections such as diarrheal diseases are significant causes of kidney disease. Awareness about how to deal with acute renal failure, which is reversible, could reduce both unnecessary mortality and morbidity. In some countries there is a lack of basic knowledge about diagnosing and treating kidney stones. A World Kidney Day could play an important role in educating physicians and the public about all these issues. Several international medical organizations have established effective special days to draw attention to specific diseases. The primary purpose of these days is to bring the specific disease to the forefront as an issue for personal/family health, to provide information about early symptoms, and the simple clinical and laboratory tests available for diagnosis. The International Society of Nephrology and the International Federation of Kidney Foundations have decided it is time for our organizations to follow suit by establishing a World Kidney Day as be one additional instrument to help achieve better understanding of kidney disease. The hope is to enlist every national kidney society, every local kidney foundation worldwide and others to join with us. We believe the kidney day will be recognized by world bodies as other special days have been. Media attention, interviews with affected patients, community awareness programs and professional education efforts all create awareness that affect public attitudes and behavior towards prevention and early treatment of the specific disease being profiled. Kidney disease, with its devastating consequences when left untreated, is one that would benefit from this type of public exposure. An initial World Kidney Day in March 9, 2006 will prepare the way for a full inauguration on March 10 2007. It will be vital that all nephrologists become involved. It is our hope that World Kidney Day will be important not only to North America and Europe, but in all developing countries, in places with disparate economies like Myanmar, Yemen, Angola and Bolivia. . The challenge is great, but the promise is even greater that by working together we can achieve a major reduction in the global burden of kidney and cardiovascular disease. We must act, and act now. -------------------------------------------------------------------------------------------------- |
回复此楼
|
积极宣传世界肾脏日 唤起全社会对慢性肾脏病的重视 中华医学会肾脏病学分会 最近，国际肾脏病学会（ISN）和国际肾脏基金联合会（IFKF）联合提出倡议，将每年3月份的第二个星期四定为“世界肾脏日”，其目的是促进医生、护士、卫生部门和政府决策者对慢性肾脏病的重视，强化个人和家庭对慢性肾脏病护理及治疗的认识，来减少这个沉默的“杀手型”疾病对个人和社会的影响，号召及激励全世界为遏制慢性肾脏病做出努力！第一个世界肾脏日定为2006年3月9日。 从全世界的总体情况来看，慢性肾脏病的防治正面临严峻挑战。这种挑战主要表现为慢性肾脏病防治具有患病率高、合并心血管疾病率高和死亡率高的“三高”以及知晓率低、防治率低和合并心血管疾病认知率低的“三低”特点。因此，即使是21世纪的今天，世界上多数国家和地区的大多数患有慢性肾脏病或高血压的患者，仍没有得到早期诊断和及时、有效的治疗。而在大多数发展中国家，多数终末期肾病（尿毒症）患者，在未能获到透析治疗或肾移植的机会前就已过早死亡，所以发展中国家（包括我国）慢性肾脏病防治面临的挑战更为严峻。 流行病学调查证据表明，慢性肾脏病已经成为一个威胁全世界公共健康的主要疾病，这是公共卫生学专家和医学专家最近十几年来才认识到的客观事实。在发达国家中（如美国和荷兰），普通人群中约有6.5%～10％患有不同程度的肾脏疾病，其中美国的肾脏病病人数已经超过2000万；医院每年收治肾脏病病人高达100多万，而得了肾脏病未去就医的人数要比收治的病人数大得多。中国目前尚无详实的慢性肾脏病流行病学调查数据，初步结果显示，40岁以上人群慢性肾脏病的患病率约为8％～9％，令人震惊。 随着慢性肾脏病的不断进展，发生终末期肾病和心血管疾病的危险大大增加。近期临床研究发现, 尿毒症患者心血管不良事件及动脉粥样硬化性心血管病比普通人群高20倍。美国国家肾脏基金会工作组的资料表明，在肾脏病的各个阶段中，心血管疾病都是病人死亡的首要原因；在血肌酐≥1.7mg/dl的慢性肾脏病病人中有58%死于心血管疾病, 心血管疾病死亡率是普通人群的15倍以上（尿毒症患者心血管疾病死亡率是普通人群的35倍！）。 另一方面，肾脏疾病的医疗费用十分高昂。美国卫生组织的数据表明，虽然慢性肾脏病和尿毒症患者总数只占医疗人群的7％，但他们的医疗费用却占了美国医疗预算费用总额的24％；尿毒症患者每人每年的透析费用需65,000美元（约50万人民币），肾移植每年需40,000美元（约32万人民币）。在我国，由于医务人员无私奉献，技术服务价格非常低廉，应用同样产品的透析费用仅为发达国家的十分之一；即使如此，如果缺乏充分的医疗保障，一个普通家庭也难以承受透析费用的沉重负担，以致发展中国家的大多数尿毒症病人目前还无法得到及时的透析治疗。 面对慢性肾脏病的严峻挑战，我们怎么办？我们认为，慢性肾脏病防治中“三高”、“三低”的现象再也不能继续下去了！我们要尽早实现慢性肾脏病的知晓率高、防治率高、合并心血管疾病认知率高的新“三高”，去战胜慢性肾脏病；让过去的“三高”逐步变成低患病率，低合并心血管疾病率和低死亡率的新“三低”。因此，现在是我们大家都来重视慢性肾脏病的时候了！也是我们行动起来的时候了！ 实现慢性肾脏病防治新的“三高”和“三低”，是一项非常光荣而艰巨的使命。所有肾科医生、内科医生、全科医生的积极参与，是取得成功的重要条件。公共卫生学专家提出，“全科医生是慢性肾脏病防治的第一线卫士。”我们认为，如果全科医生的积极性都发动和组织起来，慢性肾脏病的防治就一定会成功。政府的重视、媒体的关注、社区的介入、职业的培训、预防的宣传以及病人的教育等，对提高广大群众预防和早期治疗慢性肾脏病的认识，都会产生巨大的影响和力量。 面对慢性肾脏病的严峻挑战，我们要从以下几个方面做起：1、鉴于我国目前缺乏慢性肾脏病流行病学数据的现状，将在全国开展肾脏病流行病学研究，从社会、个体的角度探讨肾脏病发病机制和防治手段，为国家制定相关政策提供基础数据；2、早期预防：对可能引起慢性肾脏病的疾患（如糖尿病，高血压病等）和危险因素（如吸烟，高脂血症等）进行及时有效的治疗或控制，防止其发生；3、及时治疗：对已有轻、中度慢性肾脏病的病人及时进行治疗，延缓或逆转慢性肾脏病的进展，防止尿毒症及其心血管等并发症发生。其中，早期预防具有更为重要的意义，如何在全体居民中通过健康检查或疾病普查，早期发现可能引起各种慢性肾脏病的常见疾病，并及时进行有效治疗，是降低其发生率、改善其预后的基本途径。这项工作的任务十分艰巨而繁重，需要动员大量人力、物力及财力。“千里之行，始于足下”，让我们保持一个清醒而明确的认识，确定一个长远战略目标，扎扎实实地从点滴工作做起。 世界肾脏日是世界各国人民的重要日子，也是中国人民的重要日子。中华医学会肾脏病学分会已经行动起来，将每年3月份的第二个星期四作为“世界肾脏日”的宣传日，并提出了“关爱健康，呵护肾脏――及早诊断，积极预防”的口号，在全国范围内，掀起了重视及认识慢性肾脏病的热潮，让我们紧密团结起来，从现在开始，向攻克慢性肾脏病堡垒的方向进军！让我们共同努力，顽强奋斗，战胜疾病，为民造福。 执笔专家：中华医学会肾脏病学分会主任委员 陈香美教授 中华医学会肾脏病学分会常务委员 郑法雷教授 中华医学会肾脏病学分会秘书 章友康教授 国际肾脏病学会理事 林善锬教授 |
3楼2006-03-03 23:29:13
|
J Am Soc Nephrol.，2006 Feb 1 特别宣言 世界肾脏日：重视肾脏的时代已经来临 Collins AJ, Couser WG, Dirks JH, Kopple JD, Reiser T, Riella MC, Robinson S, Shah SV, Wilson A. Developed by the International Federation of Kidney Foundations (IFKF) and the International Society of Nephrology (ISN), Committee for World Kidney Day. 国际肾脏病学会（ISN）和国际肾脏基金联合会（IFKF）联合倡议每年3月份的第二个星期四为“世界肾脏日”。此举的主要目的是希望引起全球对慢性肾脏疾病（chronic renal diseases, CKD）及相关的心血管疾病重视。并借此将肾脏病信息传送给政府的卫生官员、全体医生以及相关专业人员、个人和家庭。 从全世界来看，大多数患有慢性肾脏疾病或高血压的患者没有得到早期诊断。即使诊断了也没有得到治疗或良好的治疗。至今终末期肾脏病患者在大多数国家和地区还无法接受透析或移植治疗，只有死亡。 为此，现在是我们大声疾呼的时候了。因为，肾脏疾病不被重视已有很长时间。实际上，虽然我们已有简单易行的早期发现和有效的防治方法，但是，还没有被广泛知晓和应用。因此，现在是引起全世界人们的重视时候，同时，还要让人们知道治疗此病每年需要数十百亿美元的巨额负担。 慢性肾脏疾病和糖尿病、高血压及心血管疾病具有相互关系，CKD是导致上述疾病高发生和高死亡的重要原因，并造成健康保险的巨额负担。CKD也明显增加心脑血管疾病的危险性。实际上，肾脏疾病可通过简单的常规方法进行检测，如检查血肌酐、尿蛋白等而发现。慢性肾脏疾病以及相关的心血管并发症也可以有效预防和治疗的方法，如良好的控制血压、控制血糖和降低血脂等。肾脏保护措施如ACEI和ARB的应用可以。延缓或阻止CKD的发展。因此对肾脏病的重视不仅是一个公众的健康问题，从而， 减少了终末期肾病以同时也减少了其相关的心血管疾病。 过去，曾有公共卫生学和生物医学专家认为肾脏疾病不是一个常见和花费巨大的疾病。然而，最新的证据表明，患肾脏病的人数远多于人们的想象。在发达国家每年诊治100多万肾脏病人中，大约25万为新增病人。在美国和荷兰，普通人群中有6.5%～10％患有不同程度的肾脏疾病，如此可见其严重性。随着糖尿病和高血压发病率的增高，肾脏疾病也在发展中国家快速增长。然而，由于每例透析的费用每年需65，000美金，肾移植每年也需40，000美金，因此，除发达国家外，大多数病人都无法得到适当的治疗。 一些新的资料显示，ESRD病人增加的速度减慢了，此在一些人群中确实如此。但这些现象与糖尿病人群应用ACEI及ARB，血压、血糖得到良好控制有关。然而，Ⅱ型糖尿病及相关的代谢综合征仍是全球的大问题，还有很多的工作要做。就全球而言，到2030年Ⅱ型糖尿病病人将增加至154～360百万人。其中至少40%有肾脏疾病，也增加心血管疾病的危险性。如果不能早期诊断和治疗，将有10%以上的病人发展至终末期肾病（ESRD）。因此，我们必须尽最大努力减少终末期肾脏病的发生，至少应减慢肾脏病发展的进程。 对于政府来说，重视肾脏疾病又是一个明显的公共健康问题。因为早期发现和预防是最有效的防治慢性肾脏疾病及其相关糖尿病和心血管疾病的方法。其内容包括：良好的血压控制，尽早提醒肾科医生进行全面的干预治疗，包括接种流感、肺炎球菌疫苗等，就可减少CKD病人由于感染而住院率的机率4倍以上；而精确的血肌酐和尿蛋白的检测则有利于慢性肾脏病人肾功能的监测。 接受透析或移植的病人最直接的原因就是肾脏疾病。早期发现和干预治疗可挽救受损的肾脏。ESRD两个主要病因高血压和糖尿病,两者具有明显的基因关联性，因此，肾脏病人应重视家族性遗传问题。遗传性疾病如多囊肾，有明显的家族遗传性。在一些发展中国家，疟疾、AIDS、结核和儿童感染如小儿腹泻等可引起肾脏疾病。如何及时处理好急性肾衰竭（ARF），以及去除一些是可逆的，导致肾脏损害的情况，也可明显减少相关疾病的患病率和死亡率。在一些国家，还不能很好地诊断和治疗肾结石。世界肾脏日可在所有的议题方面教育我们的医生和民众。 一些国际医学组织已经建立了相应的国际日来引起人们对特殊疾病的认识。建立这样一个特殊的日子就是呼吁个人和家庭重视这个问题，并根据早期的症状和简单的实验室检查作出早期诊断。ISN和IFKF建立世界肾脏日——使之成为唤起人们关注和了解肾脏疾病的重要途径。我们希望全世界各国肾脏病学会和肾脏基金会联合起来，共同创建世界肾脏日，使之象其他国际日一样得到世界认可。 媒体的关注，病人的访问，社区的重视以及职业教育等都会产生足以影响大众对预防和早期治疗慢性肾脏疾病的认识。如果不予治疗，慢性肾脏疾病作为一个重要疾病将会成为重大的公共健康问题。 2006年3月9日是第一个世界肾脏日，也将为2007年3月8日正式建立世界肾脏日做准备。所有肾科医生的参与是关键。我们希望世界肾脏日将不仅是北美和欧洲的重要日子，也是发展中国家的重要日子。挑战愈大，我们的责任更重大。让我们团结起来，从现在开始，共同克服肾脏疾病和心血管疾病的世界难题，为民造福。 参与译文专家：中华医学会肾脏病学分会副主任委员 余学清教授 国际肾脏病学会理事 林善锬教授 国际肾脏病学会理事 王海燕教授 中华医学会肾脏病学分会常务委员 郑法雷教授 中华医学会肾脏病学分会副主任委员 李学旺教授 中华医学会肾脏病学分会主任委员 陈香美教授 |
2楼2006-03-03 23:28:44
